"Treatment (and thus public health) is impeded by 'communications and cultural issues.' Basically, we can't get them to take meds."
And less than two months from now, a state-funded program designed to address those issues is scheduled to end -- causing some local government and health officials to fear a difficult situation is about to get dangerously worse.
Since 2007, the Indiana Family and Social Services Administration (FSSA) has paid Indianapolis-based Advantage Health Solutions to coordinate health care for Fort Wayne's Medicaid-eligible Burmese population. But, citing budget constraints, the state is ending the program that organizes 1,300 monthly medical appointments and has been credited with increasing refugees' willingness to seek the care needed to ensure their health, and that of the community.
"Up to 90 percent of the referral from the Department of Health after medical screening went unmet. Today, Advantage has a 90 percent follow-up rate on those referrals," said Meg Distler, executive director for the St. Joseph Community Health Foundation, which helps coordinate the program. "The great tragedy will be that many of the people using Advantage to help them get their care will be lost, hitting the emergency departments or going untreated after July 1."
Advantage has provided a variety of services intended to make the local health care system more accessible to Burmese, many of whom are poorly educated; came to Fort Wayne from refugee camps; and have no understanding of English, health care or seemingly simple concepts such as taking medicine or keeping appointments.
Advantage has worked to overcome those barriers, Allen County Health Commissioner Deborah McMahan said, by providing services such as transportation, translation and coordination of care. Local officials say Burmese often seek routine treatment in emergency rooms or use emergency services for transportation.
"Our first impulse is to treat everybody the same," McMahan said, noting that one-size-fits-all-approach doesn't always work with people unfamiliar with American culture. "We should focus not on the process, but the outcome. When people don't make their appointments, a lot of people are hurt: not only them, but the doctor and other patients."
McMahan met with other local officials Monday to discuss a possible response to the loss of the Advantage program, which she estimated cost more than $100,000 a year. One possibility, she said, would be to create some sort of "care coordinator" for the local Burmese population, which is now estimated at 5,000.
"We invited them here," she said. "We should be able to assist them." The federal government requires the state to improve access to health care for refugees, and Distler noted that some insurance companies receiving Medicaid funding may be able to continue services now provided by Advantage -- possibly at a lower cost to taxpayers.
"But the great fear is that Advantage has done such a phenomenally good job, and this is such a medically complex population."
Marcus Barlow, FSSA director of communications and media, said the agency's intent is for services to refugees to remain the same. "The largest difference now will be educating the (Burmese) population to go directly to their health plan to coordinate these services instead of going to Advantage."
"Advantage has been extremely beneficial in helping the Burmese with health issues they weren't prepared for," added Parkview Health's Chief Operating Officer Sue Ehinger. "How do we best incorporate them into the community?" New language-translation technology not available when the Advantage program began can help, said Lutheran Community liaison Barb Schoppman.
In a February letter to FSSA Secretary Anne Murphy, Mayor Tom Henry said Fort Wayne is the "epicenter of the Burmese population in the U.S.," adding that the "impact on this community has been significant, including repercussions on the schools, housing and other institutions. However, no segment of the community has been more burdened by this population than the health system."
Ending the Advantage program without an effective follow-up strategy, Henry warned, "will put public health at risk, lead to a less-healthy refugee population, overburden the local health care system and ... , cost the state more than it is currently spending on refugee health care."
Minn Myint Nan Tin, Burmese Advocacy Center executive director, 2826 S. Calhoun St., said her agency will continue to work with refugees to improve access to transportation, education and medicine when the Advantage program ends.
"It will be more difficult, but we don't want to give them fish. We want to teach them how to fish," she said.
Related Reads:
[widget:related_reads__healthstress]
Indiana State Health Program's End Will Affect Local BurmeseOriginally from: http://www.nursinglink.monster.com/news/articles/12715-indiana-state-health-programs-end-will-affect-local-burmese
View this post on my blog: http://travelnursesuccess.com/indiana-state-health-programs-end-will-affect-local-burmese
No comments:
Post a Comment